EAST TEXAS BORDER HEALTH CLINIC (NPI# 1659567337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659567337 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS BORDER HEALTH CLINIC |
| Practice Address |
106 N Alley Street Jefferson TX 75657-1408 |
| Mailing Address |
Po Box 1326 Marshall TX 75671-1326 |
| Practice Telephone | 9036658453 |
| Practice Fax Number | 9036658496 |
| Mailing Telephone | 9039273782 |
| Mailing Fax Number | 9034724577 |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | CARLA ROADCAP (CEO) |
| Authorized Official Telephone | 9039273782 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 174139903 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366718 | East Texas Border Health Clinic | Clinic/Center | 1411 College Dr, Texarkana, TX 75503-3533 | 2020-11-04 |
| 1780295741 | East Texas Border Health Clinic | Clinic/Center | 705 S Grove St, Marshall, TX 75670-5220 | 2020-08-13 |
| 1811485055 | East Texas Border Health Clinic | Clinic/Center | 815 S Washington Ave Ste 203, Marshall, TX 75670-5341 | 2018-04-24 |
| 1588092472 | East Texas Border Health Clinic | Clinic/Center | 401 N Grove Street, Marshall, TX 75670-3255 | 2013-10-31 |
| 1700134996 | East Texas Border Health Clinic | General Practice | 1500 W. Grand Ave., Marshall, TX 75671 | 2012-08-21 |
| 1194332155 | East Texas Border Health Clinic | Social Worker | 1011 S William St, Atlanta, TX 75551-3245 | 2020-09-24 |
| 1023630969 | East Texas Border Health Clinic | Clinic/Center | 622 S Grove St, Marshall, TX 75670-5251 | 2020-05-14 |
| 1528616992 | East Texas Border Health Clinic | Pharmacy | 1400 College Dr, Texarkana, TX 75503-3536 | 2019-08-29 |
| 1548745383 | East Texas Border Health Clinic | Counselor | 4077 Jefferson Ave, Texarkana, AR 71854-1509 | 2018-09-27 |
| 1053845636 | East Texas Border Health Clinic | Clinic/Center | 618 S Grove St Ste 100&300, Marshall, TX 75670-5294 | 2017-04-20 |
| Street Address |
106 N ALLEY STREET |
| City | JEFFERSON |
| State | TX |
| Zip Code | 75657-1408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780131995 | Kimberly George | Case Manager/Care Coordinator | 261 Ma County Road 3430, Jefferson, TX 75657 | 2016-09-06 |
| 1124116561 | The Med Shop | Durable Medical Equipment & Medical Supplies | 110 N . Walnut, Jefferson, TX 75657 | 2006-10-11 |
| 1487644068 | Denise Sepulvado Norris | Occupational Therapist | 1404 Marion County Road 3509, Jefferson, TX 75657 | 2005-10-25 |
| 1700870185 | Robin Lynne Gale | Nurse Practitioner | 219 N Polk St, Jefferson, TX 75657 | 2005-08-31 |
| 1700072477 | James Leo Carroll | Physical Therapy Assistant | 339 Tangiers, Jefferson, TX 75657-0598 | 2007-09-17 |
| 1952397739 | Pine Hill Nursing and Rehabilitation Lp | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2005-09-27 |
| 1124495486 | Fannin County Hospital Authority | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2015-08-21 |
| 1598910291 | Jefferson I Enterprises, LLC | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2008-11-21 |
| 1558404293 | Jefferson Isd | Local Education Agency (LEA) | 1600 Martin Luther King Dr, Jefferson, TX 75657-1061 | 2007-02-14 |
| 1730352667 | Demetria Rena Parker | Nurse's Aide | 506 E Harrison St, Jefferson, TX 75657-1106 | 2008-04-11 |
| Find all providers in zip 75657 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538411921 | Access Health Louisiana | Clinic/Center | 240 Riverdale Dr, Jefferson, LA 70121-3507 | 2012-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366718 | East Texas Border Health Clinic | Clinic/Center | 1411 College Dr, Texarkana, TX 75503-3533 | 2020-11-04 |
| 1366043689 | Legacy Community Health Services, Inc. | Clinic/Center | 1900 Strawn Rd., Houston, TX 77039-2017 | 2020-11-03 |
| 1275134595 | Legacy Community Health Services, Inc | Clinic/Center | 507 Crenshaw Rd., Houston, TX 77034-1543 | 2020-11-03 |
| 1912508235 | Legacy Community Health Services, Inc | Clinic/Center | 120 Westheimer Rd., Suite F, Houston, TX 77006-3332 | 2020-11-03 |
| 1720688534 | Barrio Comprehensive Family Health Care Center, Inc. | Clinic/Center | 11930 Us Highway 90, Suite 110, San Antonio, TX 78252 | 2020-10-30 |
| 1053918516 | Legacy Community Health Services, Inc. | Clinic/Center | 13703 Aldine Westfield Rd, Houston, TX 77039-2001 | 2020-10-07 |
| 1205449386 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Drive Suite 1305, Wharton, TX 77488 | 2020-08-28 |
| 1568075638 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Center, Suite 1317, Wharton, TX 77488-9719 | 2020-08-28 |
| 1144831835 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Center Drive Suite 1315, Wharton, TX 77488-9719 | 2020-08-14 |
| 1780295741 | East Texas Border Health Clinic | Clinic/Center | 705 S Grove St, Marshall, TX 75670-5220 | 2020-08-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.